If you are a person with HIV or AIDS, living in Vermont is a mixed blessing. A socially pro- gressive atmosphere combined with a small population make ac- cess to social and medical services much easier here, in many ways, than in most other places. Big cit- ies have greater expertise in deal- ing with HIV disease and are gen- erally fairly liberal in their appli- cation of social services, but they deal with such huge numbers of HIV-positive people that it is dif- ficult to get the personalized atten- tion the condition increasingly de- mands. By virtue of their size, most small communities are able to deliver highly individualized care. But HIV is generally more stigmatized and treatment strate- gies less up-to-date in rural areas and small towns. _ If Vermont can be said to offer some of the best of both worlds, we must also recognize that it has a unique set of difficul- ties. The greatest problem with HIV policy and services in this state is related to our small popu- lation. One of the driving forces in HIV care in big cities is a larger body of consumers. The critical role organizations like ACT UP and TAG have played in the ac- celerated development of medical and social services in large cities is a positive example of how much influence people with HIV and AIDS can have, need to have, on the effective management of their condition. Here in Vermont, we simply haven't had an adequate number of consumers with HIV to estab- lish a serious political or social presence. We have necessarily re- lied on our ASO’s (AIDS Service Organizations) and medical pro- viders to keep us current medi- cally and to maximize our chances of survival. The adrninistrative and political savvy of a few indi- viduals, notably Mary Pierce, who manages the AIDS Medication she's 15, &iSales”.I-an IIIIW can SIIE BIIIIIIBGI Wllll IIBEIS? ' Outright Vermont’s pen-pal program connects lesbian, gay, bisexual, transgender, and questioning youth statewide. Cal 1-.800-Ell! CHM wntcan vnu Ill]? _ llolunteer. Make 8 fillflllflifll lilllllflllllllllll. V0" can make 3 difference. Assistance Program (AMAP) at the Department of Health, Keith Goslant, the Governor's liaison for Gay and Lesbian Affairs in Mont- pelier, and Tim Palmer, the Execu- tive Director of Vermont CARES, has carried us a great distance. But without the visible and vocal sup- port of consumers living with HIV, theirs has been and will continue to be an uphill fight. As long as we, the PWA's of Vermont, continue to let others do our fighting for us, we will con- tinue to lag behind major urban areas in the quality of care and ser- vices we are receiving. We must speak up for ourselves and for each other. It is for this reason that the now defunct Vermont AIDS Council formed the Public Policy Steering Committee as its final act. The Council directed that the Steering Committee be entirely composed of people living with HIV or AIDS, thereby giving PWA's genuine and direct influ- ence on policy-making in Montpe- lier,. and enabling us to bring the standard of HIV-related care and services in Vermont up to where it should be. 1 Though it has been in exist- ence for only a few months, the Public Policy Steering Committee is already in danger of losing its teeth. The composition of the Steering Committee has been al- tered from that envisioned by the AIDS Council to include ASO’s and service providers in its voting body. The rationale of the Com- mittee members who voted for the change was essentially that PWA's can’t handle the responsibility. As I the only member of the Commit- tee to oppose the change, I felt, and still feel, that no particular effort has been made to include PWA's in policy—direction or to empower them in any way. Vermont PWA's have ac- cepted too many compromises al- ready under the guidance of orga- nizations that claim to serve and represent us. The formulary of drugs covered by AMAP is a good indicator of how effective our rep- resentation has been in the legis- lature. The forniulary of AIDS medications available to Vermont- ers is skeletal compared to those of cities like New York and San Francisco. The formularies of these major cities are larger be- cause PWA's have lobbied hard and effectively in their state legis- latures to get them expanded to meet their needs. If the Public Policy Steering Committee is going to serve the function it was created to serve, which is to empower PWA's in the improvement of HIV-related policy and care in Vermont, it des- perately needs new blood. As it stands, the Committee is largely composed of individuals who have been involved for many years in the Vermont PWA Coali- tion. While their commitment is unquestionable, it is clear that the Coalition has not been able to muster adequate involvement of its constituency to keep Vermont up to date with respect to treat- ment, social services or public policy. Do not accept the idea that you are represented here. You are not. I have trouble believing that there are no women, no people of color, no one without insurance or, for that matter, no people under the age of 30 living with HIV in this state. You can still make a dif- ference. The Public Policy Steering Committee meets monthly in Montpelier. Come to the meetings. Talk to the Committee about the hardships you face, the expenses you cannot meet, the services you wish you could access. Do not let this potentially powerful voice in Montpelier degenerate into squab- bling over insurance deductibles. Don't think that your interests are represented by treatment provid- ers such as the Comprehensive Care Clinic or Dartmouth- Hitchcock. Of the three meetings of the Committee to date, not one has been attended by a provider, though they have repeatedly said that they would come. The AIDS crisis has entered a new phase — it has become a movement. We are finding more and more ways to live with HIV and, as a result, our needs are be- coming increasingly complex. The burden in on us to make those needs heard in the legislature, in ou.r AIDS service organizations and in treatment facilities. If we are to have these needs met, we must heed the first. commandment of living with HIV, as described by Lark Lands, the PWA Coalitio'n’s guru: DO THE WORK. It is not as _ hard as you think and the benefits are greater than you probably imagine. Please call Tim Palmer at Vermont CARES for the upcoming Public Policy Steering Committee meeting date, time and location. The number is 1-800-649-AIDS. You are the experts when it comes to living with HIV and your ex- pertise is sorely needed in Mont- pelier. OUT IN THE MOUNTAINS — FEBRUARY 1998 — 19 Susan McKenzie MS. Licensed Psychologist—Master Experienced therapist specializing in the individual and relationship issues of Lesbian Women and Gay Meii Quechee Montpelier Norwich; 802 295-5533 Insurance Accepted-Sliding Fee Scale WOMEN’c%?CHOICE GYNECOLOGIC ASSOCIATES 23 Mansfield Avenue, Burlington, Vermont 05401 802-863-9001 Fax:802-863-4951 Cheryl A. Gibson M.D. Susan F. Smith M.D. PRIMARY CARE IN FRANKLIN COUNTY Mara Vijups, M.D. Family Practice Specialist NMC Rural Health Services Caring for Adults & Children East Fairfield Enosburg Swanton 933-5831 868-2454 827-3032 Forest Family Dentistry Laurie Ann Forest, D.D.S. The Heritage I Building 81 River Street Montpelier, VT 05602 (802) 229-0033 IRLNCIK lRlElCCll-l|lO, M.D.. IRA./\.P. specializing in iidolesceiit and pediatric medical care POB 806. 184 Rt. 7 South Milton, VT 05468 (888) 527-8189 . rrecchio@t0gether.net Live your highest potential . WHITE PINE POLARITY Geralyn Roscoe, RN, RPP, A Greenwind DeCelle, APP North Wolcott, Vermont Burlington, Vermont 802-888-3087 (unity lorum www.vtpriile.org